MEDICARE: DR. SHU-CHUNG SHIH CHENG M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	135105	NY

General Provider Information

NPI Number	:	1689645475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHU-CHUNG SHIH CHENG M.D.

Provider Business Mailing Address
First Line	:	29 FENIMORE RD
Second Line	:
City	:	SCARSDALE
State	:	NY
Zip	:	10583-2250
Country	:	US
Telephone Number	:	914-725-0009
Fax Number	:	914-725-0009

Provider Business Practice Location Address
First Line	:	2094 PITKIN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11207-3509
Country	:	US
Telephone Number	:	718-240-0480
Fax Number	:	718-240-0564

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	07/08/2007

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